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Fertility Problems: Should I Be Tested?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Fertility Problems: Should I Be Tested?

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Get the facts

Your options

Have tests to try to find out the cause of
infertility.

Don't have tests. To make family planning decisions,
use the information you already have.

Key points to remember

If you are younger than 35 and are trying to
get pregnant (conceive), most doctors suggest trying well-timed sex for at
least 1 year before thinking about testing. The best time to conceive is just
before
ovulation. Some couples find that they have been
missing their most fertile days when trying to conceive.

If you
are a woman 35 or older and have tried well-timed sex for 6 months, you might
want to think about infertility testing before age-related problems make it too
hard to conceive.

Infertility tests may find what is causing the problem.
Sometimes you can be treated at the same time.

Testing and
treatment can be stressful, costly, and sometimes painful. You may need only a
few tests, or you may need many tests over months and years.

If
you decide to have infertility testing, talk with your doctor about how much
testing you are willing to do and for how long. You may only want to have tests
for problems you are willing to treat or that will help you move on to other
options, such as adoption.

Tests can't always find the cause of infertility. And not all
infertility problems can be treated.

It can be stressful for you and your partner to
find out the reason for infertility. Knowing where the problem is may create
feelings of guilt and blame and may put strain on your relationship. Not being
able to find any cause can also create stress. You may want to talk with a
counselor or join an infertility support group before you make your decision.
Talking with other people can help you feel less alone.

Tests for infertility can range from a simple blood test to surgery. If you
decide to have testing, your doctor will want to check you and your partner at
the same time.

Basic tests can show
if there are problems with eggs or sperm. Depending on the results, the test
may be repeated, or you and your partner will be treated with medicines and
hormones. These tests may include:

Basal body temperature
tests.

Blood tests.

Semen analysis.

Advanced tests check the reproductive
organs of both partners. These tests look for diseases or fertility problems
that might be treated. These tests may include:

Based on your
test results, your doctor can help you decide about your next testing or
treatment option. Take some time to think about what you have learned from each
test and what you want to do next.

For example, if your first
test results are normal and no clear reason is found for your fertility
problem, you may:

Keep trying to conceive on your own, having
sex just before
ovulation to increase your chances of getting
pregnant.

Have advanced tests to find out a cause for your
fertility problem. These tests will check your
fallopian tubes to be sure that eggs can enter the
tubes, be fertilized, and start to grow in the uterus. The tests may involve
cutting or poking, and they have risks, such as cramping or infection.

Tests can't always find the cause of infertility. And not
all infertility problems can be treated.

Depending on the results
of these tests, your doctor may suggest treatment, such as:

Testing and treatment can be costly, stressful, and sometimes painful.
Before starting, talk about how much testing you are willing to do and for how
long.

You may decide to have the basic tests only and to stop
when you have enough information. Or instead of advanced testing and treatment,
you may decide to keep trying to get pregnant on your own or to adopt a child.
Your decision will be based on your health, age, goals, and values.

It would be easier for you
to make family planning decisions with test results.

Compare your options

Compare

What is usually involved?

What are the benefits?

What are the risks and side effects?

Have infertility testing
Have infertility testing

You have one or more
infertility tests to find out why you and your partner
are having problems getting pregnant.

You keep track of how often you and your partner have sex, and
you talk about this with your doctor.

You decide how much testing to do, and you stop when you have
enough information. Based on the test results, you may decide to get fertility
treatment.

You may be able to find
out why you are having problems getting pregnant.

Some tests can
find the problem and treat it at the same time.

You may
need many tests over many months or years. Tests can't always find the cause of
infertility. And not all infertility problems can be
treated.

Testing is stressful and can be costly.

Basic
tests, such as semen analysis and blood tests, have no risks or side effects,
and they don't cause pain.

Advanced tests or surgery may require a
cut in the skin and can be painful. They have a higher chance of problems after
the test, such as cramping or infection.

Don't have infertility
testing Don't have infertility
testing

You keep trying
to conceive on your own, having sex just before
ovulation to increase your chances of getting
pregnant. Some couples find that they have been missing their most fertile days
when trying to conceive.

You consider other options for parenting, such as
adoption or raising a foster child.

You avoid the
cost, stress, and risks of infertility testing.

You
may have an infertility problem that can be treated, but you may not know
it.

Personal stories about infertility testing

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

Most
couples we know seemed to get pregnant after just a few months of trying. We've
been trying now for about 5 or 6 months and still haven't gotten pregnant. But
we aren't sure that we have been having sex at the right time of the month, so
we got some information about how to calculate the fertile time. We are going
to see if working on our timing for a few months helps us get pregnant. If it
doesn't, we'll see our doctor to talk about the next step.

Lynn, age 33, and James, age
40

I didn't have any trouble getting pregnant
with my first child. But my second husband and I have been trying to have a
baby for about a year now, and I still haven't gotten pregnant. Since he
doesn't have any children of his own, we can't be sure which one of us may have
a problem. We have been having sex at the right times. We agree that it's time
to find out whether there may be a problem. We don't want to wait too long,
because we'd like the new baby to be able to grow up with his or her big
sister.

Rosa, age
32

We are getting started on our baby-making a
little bit later than a lot of couples: I'm 34 and my husband is 38. It's
ironic that we have both been so successful in our careers and yet now seem to
be having trouble having a baby! We have been trying for about 8 or 9 months,
and it doesn't seem to be happening. My husband is a little on the macho side,
so he's not too keen on having a semen analysis. But I'm sure that if I agree
to have some tests, he will too.

Carol, age 34, and Dave, age
38

We've been trying to conceive for 10 months
now. Soon we'll have to start counting in years, I'm afraid. It's been a rude
awakening to discover that we can't control our ability to conceive. But since
we are both still young, we aren't too worried yet. We are going to try
tracking my wife's menstrual cycles and see if that helps before we take the
next step. If that doesn't help, I'll consider having my sperm checked.

James, age 27, and
Sabra, age 26

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have infertility testing

Reasons not to have infertility testing

Having a biological child is very important to me.

Having a biological child is not that important to me.

More important

Equally important

More important

I'm not worried about the cost of infertility testing.

I'm worried about the cost of testing.

More important

Equally important

More important

I think I can handle the stress of testing.

I'm not sure that I can handle the stress of testing.

More important

Equally important

More important

I accept that testing may not be able to find a problem or treat it if one is found.

I don't want to have a lot of tests that may not find my problem or treat it.

More important

Equally important

More important

I know that having these tests means talking with doctors about our sex life.

I'm not comfortable talking about our sex life.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having infertility testing

NOT having infertility testing

Leaning toward

Undecided

Leaning toward

What else do you need to make your decision?

Check the facts

1.1, If you are younger than 35 and have been trying to get pregnant for 4 months, is it time to think about an infertility test?

YesSorry, that's not right. If you're younger than 35 and trying to get pregnant, doctors suggest trying well-timed sex for at least 1 year before thinking about testing.

NoYou're right. If you're younger than 35 and trying to get pregnant, doctors suggest trying well-timed sex for at least 1 year before thinking about testing.

I'm not sureIt may help to go back and read "Key points to remember." If you're younger than 35 and trying to get pregnant, doctors suggest trying well-timed sex for at least 1 year before thinking about testing.

2.2, Can testing always help you find out the cause of any infertility problem?

YesSorry, that's not right. Tests can't always find the cause of infertility. And not all infertility problems can be treated.

NoYou're right. Tests can't always find the cause of infertility. And not all infertility problems can be treated.

I'm not sureIt may help to go back and read "How can you use the test results?" Tests can't always find the cause of infertility. And not all infertility problems can be treated.

3.3, Can some tests find and treat an infertility problem?

YesYou're right. Infertility tests may find what is causing the problem. Sometimes you can be treated during the test.

NoSorry, that's not right. Infertility tests may find what is causing the problem. Sometimes you can be treated during the test.

I'm not sureIt may help to go back and read "Key points to remember." Infertility tests may find what is causing the problem. Sometimes you can be treated during the test.

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Fertility Problems: Should I Be Tested?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts

Compare your options

What matters most to you?

Where are you leaning now?

What else do you need to make your decision?

1. Get the Facts

Your options

Have tests to try to find out the cause of
infertility.

Don't have tests. To make family planning decisions,
use the information you already have.

Key points to remember

If you are younger than 35 and are trying to
get pregnant (conceive), most doctors suggest trying well-timed sex for at
least 1 year before thinking about testing. The best time to conceive is just
before
ovulation. Some couples find that they have been
missing their most fertile days when trying to conceive.

If you
are a woman 35 or older and have tried well-timed sex for 6 months, you might
want to think about infertility testing before age-related problems make it too
hard to conceive.

Infertility tests may find what is causing the problem.
Sometimes you can be treated at the same time.

Testing and
treatment can be stressful, costly, and sometimes painful. You may need only a
few tests, or you may need many tests over months and years.

If
you decide to have infertility testing, talk with your doctor about how much
testing you are willing to do and for how long. You may only want to have tests
for problems you are willing to treat or that will help you move on to other
options, such as adoption.

Tests can't always find the cause of infertility. And not all
infertility problems can be treated.

FAQs

What is infertility?

You may be
infertile if you have not been able to get pregnant
after trying for at least 1 year.

A woman's fertility slowly
drops from her mid-30s into her 40s because of the natural
aging of the egg supply. A man's fertility is not affected as much by age.

Defining infertility is a personal issue. It can depend on your
age and how much time you choose to spend trying to get pregnant without
medical help.

What kinds of problems lead to infertility?

In
about 35 out of 100 couples, testing finds a male fertility problem, such as
with sperm production or ejaculation.1

In about 50 out of 100
couples, testing finds a female fertility problem with
ovulation,
fallopian tube function, or other pelvic problems.1

It can be stressful for you and your partner to
find out the reason for infertility. Knowing where the problem is may create
feelings of guilt and blame and may put strain on your relationship. Not being
able to find any cause can also create stress. You may want to talk with a
counselor or join an infertility support group before you make your decision.
Talking with other people can help you feel less alone.

What types of tests are done?

Tests for infertility can range from a simple blood test to surgery. If you
decide to have testing, your doctor will want to check you and your partner at
the same time.

Basic tests can show
if there are problems with eggs or sperm. Depending on the results, the test
may be repeated, or you and your partner will be treated with medicines and
hormones. These tests may include:

Basal body temperature
tests.

Blood tests.

Semen analysis.

Advanced tests check the reproductive
organs of both partners. These tests look for diseases or fertility problems
that might be treated. These tests may include:

Hysteroscopy.
This test looks for growths or defects in the uterus that can't be seen with
other tests.

Sperm antibody test. This test shows
whether sperm have been damaged by
antibodies.

How can you use the test results?

Based on your
test results, your doctor can help you decide about your next testing or
treatment option. Take some time to think about what you have learned from each
test and what you want to do next.

For example, if your first
test results are normal and no clear reason is found for your fertility
problem, you may:

Keep trying to conceive on your own, having
sex just before
ovulation to increase your chances of getting
pregnant.

Have advanced tests to find out a cause for your
fertility problem. These tests will check your
fallopian tubes to be sure that eggs can enter the
tubes, be fertilized, and start to grow in the uterus. The tests may involve
cutting or poking, and they have risks, such as cramping or infection.

Tests can't always find the cause of infertility. And not
all infertility problems can be treated.

Depending on the results
of these tests, your doctor may suggest treatment, such as:

Laparoscopy, to look for problems with your fallopian
tubes or ovaries.

Before you decide about testing, think about:

How important is it to you and your partner
to know why you haven't become pregnant?

How will test results
affect your family planning?

How will you deal with the stress of
testing?

How much will it cost? Talk with your doctor and your
health insurer about costs.

What else do you need to know about testing?

Testing and treatment can be costly, stressful, and sometimes painful.
Before starting, talk about how much testing you are willing to do and for how
long.

You may decide to have the basic tests only and to stop
when you have enough information. Or instead of advanced testing and treatment,
you may decide to keep trying to get pregnant on your own or to adopt a child.
Your decision will be based on your health, age, goals, and values.

Why might your doctor recommend infertility testing?

Your doctor might advise you to have infertility testing if:

You are younger than 35, have regular
menstrual periods, and have had sex during your
fertile window (the 6 days each month that you can become pregnant) for at least 1 year.

You
are 35 or older, or you have irregular periods and have had sex during your
fertile window for at least 6 months.

You are at
high risk for fertility problems and have had sex
during your fertile window for a few months.

It would be easier for you
to make family planning decisions with test results.

2. Compare your options

Have infertility testing

Don't have infertility
testing

What is usually involved?

You have one or more
infertility tests to find out why you and your partner
are having problems getting pregnant.

You keep track of how often you and your partner have sex, and
you talk about this with your doctor.

You decide how much testing to do, and you stop when you have
enough information. Based on the test results, you may decide to get fertility
treatment.

You keep trying
to conceive on your own, having sex just before
ovulation to increase your chances of getting
pregnant. Some couples find that they have been missing their most fertile days
when trying to conceive.

You consider other options for parenting, such as
adoption or raising a foster child.

What are the benefits?

You may be able to find
out why you are having problems getting pregnant.

Some tests can
find the problem and treat it at the same time.

You avoid the
cost, stress, and risks of infertility testing.

What are the risks and side effects?

You may
need many tests over many months or years. Tests can't always find the cause of
infertility. And not all infertility problems can be
treated.

Testing is stressful and can be costly.

Basic
tests, such as semen analysis and blood tests, have no risks or side effects,
and they don't cause pain.

Advanced tests or surgery may require a
cut in the skin and can be painful. They have a higher chance of problems after
the test, such as cramping or infection.

You
may have an infertility problem that can be treated, but you may not know
it.

Personal stories

Personal stories about infertility testing

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"Most couples we know seemed to get pregnant after just a few months of trying. We've been trying now for about 5 or 6 months and still haven't gotten pregnant. But we aren't sure that we have been having sex at the right time of the month, so we got some information about how to calculate the fertile time. We are going to see if working on our timing for a few months helps us get pregnant. If it doesn't, we'll see our doctor to talk about the next step."

— Lynn, age 33, and James, age
40

"I didn't have any trouble getting pregnant with my first child. But my second husband and I have been trying to have a baby for about a year now, and I still haven't gotten pregnant. Since he doesn't have any children of his own, we can't be sure which one of us may have a problem. We have been having sex at the right times. We agree that it's time to find out whether there may be a problem. We don't want to wait too long, because we'd like the new baby to be able to grow up with his or her big sister."

— Rosa, age
32

"We are getting started on our baby-making a little bit later than a lot of couples: I'm 34 and my husband is 38. It's ironic that we have both been so successful in our careers and yet now seem to be having trouble having a baby! We have been trying for about 8 or 9 months, and it doesn't seem to be happening. My husband is a little on the macho side, so he's not too keen on having a semen analysis. But I'm sure that if I agree to have some tests, he will too."

— Carol, age 34, and Dave, age
38

"We've been trying to conceive for 10 months now. Soon we'll have to start counting in years, I'm afraid. It's been a rude awakening to discover that we can't control our ability to conceive. But since we are both still young, we aren't too worried yet. We are going to try tracking my wife's menstrual cycles and see if that helps before we take the next step. If that doesn't help, I'll consider having my sperm checked."

— James, age 27, and
Sabra, age 26

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have infertility testing

Reasons not to have infertility testing

Having a biological child is very important to me.

Having a biological child is not that important to me.

More important

Equally important

More important

I'm not worried about the cost of infertility testing.

I'm worried about the cost of testing.

More important

Equally important

More important

I think I can handle the stress of testing.

I'm not sure that I can handle the stress of testing.

More important

Equally important

More important

I accept that testing may not be able to find a problem or treat it if one is found.

I don't want to have a lot of tests that may not find my problem or treat it.

More important

Equally important

More important

I know that having these tests means talking with doctors about our sex life.

I'm not comfortable talking about our sex life.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having infertility testing

NOT having infertility testing

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1.
If you are younger than 35 and have been trying to get pregnant for 4 months, is it time to think about an infertility test?

Yes

No

I'm not sure

You're right. If you're younger than 35 and trying to get pregnant, doctors suggest trying well-timed sex for at least 1 year before thinking about testing.

2.
Can testing always help you find out the cause of any infertility problem?

Yes

No

I'm not sure

You're right. Tests can't always find the cause of infertility. And not all infertility problems can be treated.

3.
Can some tests find and treat an infertility problem?

Yes

No

I'm not sure

You're right. Infertility tests may find what is causing the problem. Sometimes you can be treated during the test.

Decide what's next

1.
Do you understand the options available to you?

Yes

No

2.
Are you clear about which benefits and side effects matter most to you?

Yes

No

3.
Do you have enough support and advice from others to make a choice?

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